表面修饰人工晶状体兔眼植入扫描电镜观察

目的表面修饰硅凝胶人工晶状体植入兔眼180d，对人工晶状体表面进行分析。方法术前与术后180d对人工晶状体进行扫描电镜观察。结果表面修饰技术不影响人工晶状体表面形态，修饰后人工晶状体表面的异物反应减轻。结论表面修饰提高了硅凝胶人工晶状体葡萄膜的生物相容性。     

表面修饰人工晶状体兔眼植入形态学观察

目的观察表面修饰硅凝胶人工晶状体植入兔眼180 d后的形态学变化.方法术后180 d光镜、扫描电镜下行人工晶状体表面分析.结果修饰的人工晶状体表面黏附细胞少于未修饰的硅凝胶人工晶状体,修饰后人工晶状体表面的异物反应减轻.结论表面修饰提高了硅凝胶人工晶状体的生物相容性.     

转铁蛋白表面修饰5-Fu白蛋白纳米囊的制备

目的：以血清糖蛋白转铁蛋白为纳米囊的表面修饰剂，对5-Fu白蛋白微囊表面进行修饰，改变纳米囊的靶向特性，提高纳米囊制剂在体现人的靶向效果。方法：以双功能偶联剂戊二醛为偶联剂，用转铁蛋白为5-Fu白蛋白微囊表面进行修饰，用ELISA方法对修饰结果进行检测。结果：白蛋白纳米囊表面进行修饰，修饰量在1mg-10mg范围内成线性关系：Y=1.7112x-0.4452(r=0.95)，所修饰的转铁蛋白保持了其免疫原性（反应原性）。结论：采用文中建立的方法用转铁蛋白对白蛋白纳米囊表面进行修饰，修饰的转铁蛋白保持了其免疫原性，可与细胞表面的转铁蛋白受体结合，提高了纳米囊的主动靶向特性。     

白蛋白毫微囊的化学表面修饰

本文以靶向制剂白蛋白毫微囊为研究对象,选择人体内的正常血浆糖蛋白转铁蛋白为蛋白毫微囊的表面修饰剂,双功能偶联剂戊二醛为偶联剂,通过对白蛋白微囊表面进行修饰,改变毫微囊的靶向特性,提高毫微囊制剂在体内的靶向效果。研究结果表明:采用中文方法对白蛋白毫微囊表面进行修饰,所修饰的转铁蛋白保持了其免疫原性(反应原性),形成的免疫毫微囊具有主动靶向的特性,同时本文还对修饰后的毫微囊的孔径分布要求、靶向特性、载药量等进行了理论上的探讨。     

改良喷砂表面处理对钛表面理化性能的影响

为研究改良喷砂钛表达处理方法应用的可靠性与可行性,采用扫描电镜、X射线衍射分析技术及钛离子溶出试验,研究钛表面的形貌、喷砂镶嵌的情况、钛表面异种化合物的污染以及钛的耐腐蚀特性。结果显示：喷砂处理所得的粗糙钛表面外形极不规则、边缘锐利,且锐嵌着大量的喷砂颗粒,钛离子的溶出速度增大。经草酸改良处理后,在喷砂表面的基本开貌基础上外形相对规则、圆滑,并形成无数二级窝洞,孔径平均为2.0μm,清除了镶嵌的喷砂颗粒,消除了异种元素的污染;同时降低了喷砂钛表面钛离子的溶出速度,从而从材料学角度证实了改良喷砂表面处理在钛牙种植体中应用的可靠性。     

表面麻醉小切口白内障摘除术在高海拔地区防盲手术中的应用

目的：探讨表面麻醉小切口白内障囊外摘除术联合人工晶体植入术在高海拔地区防盲手术应用的可行性。方法：1 206例（1 206眼）高海拔地区海拔3 000m以上地区老年性白内障患者随机分为观察组601例及对照组605例,观察组行表面麻醉小切口白内障囊外摘除联合人工晶状体植入术,而对照组采用球周麻醉进行手术。观察术中麻醉效果,对比分析术后视力及手术并发症。结果：观察组麻醉成功率99.0%,其中6例改为球周麻醉,未出现麻醉意外及全身并发症,对照组球结膜水肿61例（10.1%）,眼睑皮肤青紫淤血38例（6.3%）,球后出血7例（1.2%）,提上睑肌麻痹4例（0.7%）,差异具有统计学意义（P〈0.01）。两组术后第1天最佳矫正视力及手术中并发症差别无统计学意义（P〉0.01）。结论：表面麻醉小切口白内障囊外摘除联合人工晶状体植入术具有麻醉效果好、安全性高、适应证范围广、术后外眼美观等优点,特别适于在高海拔地区防盲手术中开展。     

Er∶YAG激光处理钛盘表面的形态学观察

目的扫描电镜下观察不同能量Er∶YAG激光照射后钛盘表面的形态学改变。方法钛盘18枚,分为两大组:对照组2枚,不进行激光照射;激光组16枚,采用不同能量的激光照射。激光组按照不同能量100、150、200和250 m J,分为4小组,每组4个钛盘,以45°照射钛盘表面,照射时间5 s。激光组4个小组中,每组有2枚钛盘在无水条件下照射;另外2枚在100%H2O条件下照射。扫描电镜下观察钛盘表面的形态学改变。结果经Er∶YAG激光照射后,在无水条件下,各组钛盘表面均出现明显熔融、裂纹等变化,而且随着能量升高变化明显。在100%H2O条件下,100 m J的脉冲能量对钛盘表面无明显影响;超过100 m J,钛盘表面出现不同程度的熔融。随着能量升高,钛盘表面形态改变明显。结论 Er∶YAG脉冲能量控制在100 m J对钛盘形态影响较小。     

酵母表面展示技术及应用

酵母表面展示是近年发展的一种新的蛋白表面展示技术,能够展示需糖基化作用,二硫键异构化等翻译后修饰才具功能活性的复杂真核蛋白,本文介绍了该技术的基本原理,研究进程,筛选方法,应用及其发展前景。     

1%地卡因表面麻醉下白内障超声乳化摘除人工晶体植入术

目的:探讨1%地卡因表面麻醉下白内障超声乳化摘除人工晶体植入手术的可行性。方法:2002年10月~2004年9月,我科收治的85例(94眼),回顾性总结分析,术中采用1%地卡因表面麻醉,经巩膜隧道或透明角膜缘切口完成常规超声乳化手术,植入单片式PMMA硬性或Acrysoy折叠式人工晶体。结果:在77眼植入硬性人工晶体中,有35眼(占45.5%)在作结膜切口前,用镊子夹结膜时病人感觉疼痛,给上方结膜下注射0.2m12%利多卡因,使手术顺利完成。术中角膜上皮部分脱落6眼(占6.4%);术中晶状体后囊破裂3眼(占3.2%),均不影响手术的顺利完成。术中没有一例追加球后麻醉。结论:选择适当的病例,1%地卡因表面麻醉也是白内障超声乳化摘除人工晶体植入术中安全有效的麻醉方法。在没有其他好的表面麻醉药的条件下,它不失为好的替代品,且经济便宜。     

表面麻醉与表面麻醉联合结膜下浸润麻醉在小切口白内障囊外摘除手术中的效果比较

目的观察表面麻醉与表面麻醉联合结膜下浸润麻醉在小切口白内障囊外摘除手术中的效果。方法A组361例(361只眼)采用表面麻醉的方法;B组298例(298只眼)采用表面麻醉联合结膜下浸润麻醉的方法对白内障进行小切口白内障囊外摘除及人工晶体植入术。结果A组在表面麻醉下325例顺利完成手术,36例术中追加表面麻醉或加用结膜下浸润麻醉后完成手术。B组表面麻醉联合结膜下浸润麻醉的298例全部顺利完成手术。结论表面麻醉在小切口白内障囊外摘除及人工晶体植入术中是一种简便、安全、有效的麻醉方法。     

A comparison of surface doses for two immobilizing systems

To achieve accurate and reproducible treatments, many types of immobilizing systems have been used. Two of these systems: Alpha Cradle^™ and VacFix^™, conform around the patient to improve day-to-day treatment repositioning. The Alpha Cradle^™ system has been in clinical use for several years. The system involves tow polyurethane chemicals which upon mixing in a latex bag will expand and harden around the patient. The second system (VacFix^™) uses a 0.15 mm thick plastic bag loosely filled with 1 mm polysterol spheres. The patient lays on the bag in the treatment position and the air is evacuated from the bag. This system retains its shape for the entire treatment and can be re-used. In some patient set-ups, it is possible that the beam is modified as it passes through these devices, causing a potential change in the target dose and an increase in the patient surface dose. CT scans of the Alpha Cradle^™ and VacFix^™ systems were performed and relative densities were calculated and compared to air. Material densities and surface dose data for a Cobalt-60 teletherapy unit and a dual photon linear accelerator are presented.     

慢性体表溃疡治疗方法的疗效分析

目的:探讨美宝湿润烧伤膏(MEBO)治疗各种体表性溃疡的有效性,寻找理想的治疗方法。方法:将同期收治的52例体表性溃疡患者随机分为观察组(MEBO)组和对照组各26例,MEBO组以MEBO治疗,对照组采用传统治疗。结果:MEBO组总有效率100％,30天痊愈率明显高于对照组(x2=19．45,P< 0．005);平均痊愈时间为15．36±2．94天,明显优于对照组的20．67±3．18天(t=6．25,P<0．001)。结论: MEBO治疗各种原因所致的体表性溃疡疗效显著,方法简便,值得推广应用。     

三维超声对胎儿体表畸形的诊断价值

目的:探讨三维超声成像在胎儿体表畸形诊断的临床价值。方法:利用三维超声仪对在我院进行产前检查的妊娠20~41周的3241例孕妇、共3277个胎儿进行二维及三维超声检查,统计并比较超声诊断与随访结果。结果:140例各种发育异常胎儿,其中体表畸形胎儿34例,二维超声诊断正确者21例,9例体表畸形胎儿二维超声检查不能作出明确诊断;三维超声进一步检查诊断正确者共30例;二维及三维超声检查误诊1例胎儿足内翻,生后证实正常,漏诊1例耳廓缺失、2例多指畸形,生后随访证实。三维超声对胎儿体表畸形检出的敏感性、特异性及准确性分别为90.91%、99.97%、99.88%;二维超声对胎儿体表畸形检出的敏感性、特异性及准确性分别为63.64%、99.97%、99.60%。结论:三维超声能直观显示胎儿体表结构,三维超声检查诊断胎儿体表畸形的敏感性、特异性及准确性高,是二维超声检查的重要补充,与二维超声联合应用,可提高胎儿体表畸形的检出率。     

美宝湿润烧伤膏治疗顽固性体表溃疡疗效分析(附33例病例报告)

目的 :进一步总结美宝湿润烧伤膏 (MEBO)治疗各种体表性溃疡临床疗效 ,为推广普及提供依据。方法 :对 2 0 0 0～ 2 0 0 3年间 33例 76处不同深度、年限、部位、病因的体表性溃疡全程应用MEBO治疗 ,其中配合手术治疗 2例。结果 :33例病人 ,治愈 32例 ,治愈率 96 97% ,好转 1例 ,占 3 0 3% ,平均治愈天数为 5 8 5 5天 ,± 38 78天 ,总有效率 10 0 %。结论 :MEBO治疗各种原因所致的体表性溃疡疗效显著、疗程短、方法简易 ,值得推广普及     

Lesions of juxtacortical origin (surface lesions of bone)

A large variety of tumor and tumor-like conditions have been shown to originate from the surface of bone (Table 1). Most surface lesions are associated with periosteal reaction. The periosteum is a multipotential membrane. Its cellular composition may give rise to a variety of both neoplasms and tumor-like conditions. To avoid misinterpretation, the orthopedist, radiologist, and pathologist should be familiar with the entire spectrum of surface lesions. A better understanding of the natural history and biological behavior at different lesional maturity stages and correlation of the history with the radiographic and pathological findings is essential to establish the correct diagnosis. A history of injury or blunt trauma is very important. A stress fracture may produce a periosteal reaction acd callus that can be difficult to distinguish from osteosarcoma. In this review article, the authors wish to describe and define each term by its anatomy and radiographic features while discussing the entire spectrum of surface lesions. All the illustrative cases in this review article have been proven histologically.     

The effect of foam surface properties on postural stability assessment while standing

A common assessment of postural control often involves subjects standing on a compliant surface, such as a foam block, to make balance tests more challenging. However, the physical properties of the foam block used by different researchers can vary considerably. The objective of this study was to provide an initial approach for investigating whether two of the foam properties, i.e. density and elastic modulus, influenced recorded anteroposterior and lateral torque variance with eyes open and eyes closed. Thirty healthy adults (mean age 22.5 years) were assessed with posturography using three different types of foam block placed on a force platform. These blocks were categorised: firm foam, medium foam and soft foam by their elastic modulus. To investigate the spectral characteristics of recorded body movements, variance values were calculated for total movements, movements <0.1 Hz and movements >0.1 Hz. Results showed that anteroposterior and lateral torque variances >0.1 Hz were larger when standing on the firm foam compared with medium and soft foam and in turn were larger on the medium foam compared with the soft foam with eyes closed. Moreover, GLM and correlation analysis demonstrated that the properties of the foam blocks affected anteroposterior torque variance >0.1 Hz and lateral torque variance in all frequency ranges. In addition, the stabilising effect of vision in the anteroposterior direction had a greater influence when the subjects’ stability was increasingly challenged by the support surface, as illustrated by the higher torque variance values. In conclusion, caution should be taken when analysing balance deficits with foam test setups, because the foam properties may influence the recorded body movements.     

Development of a new 360-degree surface topography application

BackgroundSurface-topography has been used for almost two decades in the radiation-free clinical evaluation of spinal posture. So far, it was limited to the analysis of back surface and spine. In order to better understand, diagnose and treat complex spinal pathologies, it is important to measure the whole torso.Research questionPurpose of this study was to introduce and test an application that allows 360° reconstruction and analysis of the patient’s torso.MethodsThe application uses the information gathered from eight distinct scans and angles. For validation we used an Alderson phantom as an anthropomorphic body. Defined areas and volumes were measured by CT and surface-topography. Inter- and intra-rater reliability was tested in 35 healthy subjects by two observers.ResultsThe results revealed good correspondence between systems in the imaging and evaluation of the Alderson model (5.3–0.5%). Inter- (0.9–0.98) and intra-rater reliability (0.8–0.95) testing revealed good and excellent results in the detection of almost all body surface structures and measurement of areas and volumes. Only area and volume measurements using jugular notch as a reference showed partly moderate results in reliability (0.62–0.93) testing.SignificanceWe were able to introduce a novel 360° torso scan application using surface topography to reconstruct torso measurements. The results of our study showed its high validity and reliability. In the future, this application needs to be tested in patients with spinal pathologies. In summary, this new application may help to better understand, diagnose and treat patients with pathologies of torso and spine.     

Study on surface dose generated in prostate intensity-modulated radiation therapy treatment

The surface doses of 6- and 15-MV prostate intensity-modulated radiation therapy (IMRT) irradiations were measured and compared to those from a 15-MV prostate 4-beam box (FBB). IMRT plans (step-and-shoot technique) using 5, 7, and 9 beams with 6- and 15-MV photon beams were generated from a Pinnacle treatment planning system (version 6) using computed tomography (CT) scans from a Rando Phantom (ICRU Report 48). Metal oxide semiconductor field effect transistor detectors were used and placed on a transverse contour line along the Phantom surface at the central beam axis in the measurement. Our objectives were to investigate: (1) the contribution of the dynamic multileaf collimator (MLC) to the surface dose during the IMRT irradiation; (2) the effects of photon beam energy and number of beams used in the IMRT plan on the surface dose. The results showed that with the same number of beams used in the IMRT plan, the 6-MV irradiation gave more surface dose than that of 15 MV to the phantom. However, when the number of beams in the plan was increased, the surface dose difference between the above 2 photon energies became less. The average surface dose of the 15-MV IMRT irradiation increased with the number of beams in the plan, from 0.86% to 1.19%. Conversely, for 6 MV, the surface dose decreased from 1.33% to 1.24% as the beam number increased from 7 to 9. Comparing the 15-MV FBB and 6-MV IMRT plans with 2 Gy/fraction, the IMRT irradiations gave generally more surface dose, from 15% to 30%, depending on the number of beams in the plan. It was found that the increase in surface dose for the IMRT technique compared to the FBB plan was predominantly due to the number of beams and the calculated monitor units required to deliver the same dose at the isocenter in the plans. The head variation due to the dynamic MLC movement changing the surface dose distribution on the patient was reflected by the IMRT dose-intensity map. Although prostate IMRT in this study had an average higher surface dose than that of FBB, the more even distribution of relatively lower surface dose in IMRT field could avoid the big dose peaks at the surface positions directly under the FBB fields. Such an even and low surface dose distribution surrounding the patient in IMRT is believed to give less skin complication than that of FBB with the same prescribed dose.     

Study on surface dose generated in prostate intensity-modulated radiation therapy treatment

The surface doses of 6- and 15-MV prostate intensity-modulated radiation therapy (IMRT) irradiations were measured and compared to those from a 15-MV prostate 4-beam box (FBB). IMRT plans (step-and-shoot technique) using 5, 7, and 9 beams with 6- and 15-MV photon beams were generated from a Pinnacle treatment planning system (version 6) using computed tomography (CT) scans from a Rando Phantom (ICRU Report 48). Metal oxide semiconductor field effect transistor detectors were used and placed on a transverse contour line along the Phantom surface at the central beam axis in the measurement. Our objectives were to investigate: (1) the contribution of the dynamic multileaf collimator (MLC) to the surface dose during the IMRT irradiation; (2) the effects of photon beam energy and number of beams used in the IMRT plan on the surface dose. The results showed that with the same number of beams used in the IMRT plan, the 6-MV irradiation gave more surface dose than that of 15 MV to the phantom. However, when the number of beams in the plan was increased, the surface dose difference between the above 2 photon energies became less. The average surface dose of the 15-MV IMRT irradiation increased with the number of beams in the plan, from 0.86% to 1.19%. Conversely, for 6 MV, the surface dose decreased from 1.33% to 1.24% as the beam number increased from 7 to 9. Comparing the 15-MV FBB and 6-MV IMRT plans with 2 Gy/fraction, the IMRT irradiations gave generally more surface dose, from 15% to 30%, depending on the number of beams in the plan. It was found that the increase in surface dose for the IMRT technique compared to the FBB plan was predominantly due to the number of beams and the calculated monitor units required to deliver the same dose at the isocenter in the plans. The head variation due to the dynamic MLC movement changing the surface dose distribution on the patient was reflected by the IMRT dose-intensity map. Although prostate IMRT in this study had an average higher surface dose than that of FBB, the more even distribution of relatively lower surface dose in IMRT field could avoid the big dose peaks at the surface positions directly under the FBB fields. Such an even and low surface dose distribution surrounding the patient in IMRT is believed to give less skin complication than that of FBB with the same prescribed dose.     

Evaluation of the surface radiation dose and dose gradient in early stage breast cancer using high-dose-rate brachytherapy MammoSite applicator

PURPOSE: To monitor the radiation dose delivered and dose homogeneity to the skin and adjacent tissues around a MammoSite applicator. METHODS AND MATERIALS: Radiation surface dose was measured on 67 consecutive patients with Stage T1-T2N0M0 breast cancer implanted with the MammoSite balloon. Thermoluminescent dosimeters and metal oxide semiconductor field effect transistors were used to measure surface dose directly over the balloon, contralateral breast, thyroid, axilla, and inframammary fold. The dose homogeneity was retrospectively studied from the treatment plans in 25 patients. RESULTS: The mean maximum skin dose was 267 cGy, with a range of 56-488 cGy per fraction, 4 cGy (+/-2 cGy) to the contralateral breast, 8 cGy (+/-4 cGy) to the thyroid, 47 cGy to the ipsilateral axilla (+/-33 cGy), and 52 cGy (+/-47 cGy) to the ipsilateral inframmammary fold. The mean dose gradients were 127%, 110%, 99%, 96%, and 89% for inflated volumes of 35, 40, 50, 60, and 70 mL, respectively. CONCLUSIONS: All patients completed therapy with no or minimal skin reaction with radiation doses comparable to or better to external beam radiation. Considering the dose homogeneity, the larger inflated volume allows for better homogeneity of dose distribution, minimizes the volume of contiguous tissue that receives relatively high doses, and may reduce the risk of fat necrosis.